scholarly journals Clinical Outcomes of Tanezumab With Different Dosages for Patient With Osteoarthritis: Network Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Rui Hu ◽  
Ya-Feng Song ◽  
Zhi-Yan Yang ◽  
Chao Zhang ◽  
Bo Tan
Keyword(s):  
Statistical Difference ◽  
Meta Analysis ◽  
Interaction Model ◽  
The Other ◽  
Clinical Effects ◽  
Disability Rate ◽  
Safety Event ◽  
Treatment Interaction ◽  
The Difference ◽  
Meta Analyses

Background: Osteoarthritis (OA) high disability rate will increase as people getting older, and is the most prevalent form of arthritis in the future. This study identified the clinical effects of optimum doses of tanezumab for patients with OA.Method: Three electronic databases were searched up until January 15, 2021. The mean difference (MD) or odds ratio (OR) was considered an effect measure. The design-by-treatment interaction model was adopted for network meta-analyses. Analyses were conducted using WinBUGS 1.4.3 and R 4.0.5 software.Results: nine publications with 10 studies were included. Compared with placebo in network meta-analysis, except the outcomes of Western Ontario and McMaster Universities Osteoarthritis (WOMAC) stiffness subscale and joints replaced, all dosages of tanezumab in the other effectiveness outcome were superior to placebo, and the difference was statistically significant. However, there was no statistical difference among all different doses of tanezumab. Compared with placebo, except the outcomes of adverse events (AEs) and AEs of abnormal peripheral sensation, all different dosages of tanezumab weren’t superior to placebo in the other effectiveness outcome, and the difference was statistically significant. The 10 mg of tanezumab with highest SUCRA had the best effect, but it was associated with a higher safety event. Compared with placebo, except the outcomes of WOMAC stiffness subscale and joints replaced, all dosages of tanezumab in the other effectiveness outcome were superior to placebo, and the difference was statistically significant. Compared with placebo, except for the outcomes of AEs and AEs of abnormal peripheral sensation, all dosages of tanezumab in the other effectiveness outcome were superior to placebo, and the difference was statistically significant. Other direct comparisons showed no statistical difference.Conclusion: This study recommended that clinicians should give priority to the treatment of OA patients with a low dose of 2.5 mg according to the patient’s condition and actual situation. If the effect using tanezumab with 2.5 mg is not satisfactory, the increase up to 10 mg should be carefully pondered, because of a more unbalanced risk/benefit ratio.

scholarly journals Pre-post effect sizes should be avoided in meta-analyses

2016 ◽  
Vol 26 (4) ◽  
pp. 364-368 ◽  
Author(s):  
P. Cuijpers ◽  
E. Weitz ◽  
I. A. Cristea ◽  
J. Twisk
Keyword(s):  
Comparison Group ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Behaviour Therapy ◽  
Natural Processes ◽  
Cognitive Behaviour ◽  
Post Test ◽  
The Difference ◽  
Meta Analyses ◽  
Highly Cited

AimsThe standardised mean difference (SMD) is one of the most used effect sizes to indicate the effects of treatments. It indicates the difference between a treatment and comparison group after treatment has ended, in terms of standard deviations. Some meta-analyses, including several highly cited and influential ones, use the pre-post SMD, indicating the difference between baseline and post-test within one (treatment group).MethodsIn this paper, we argue that these pre-post SMDs should be avoided in meta-analyses and we describe the arguments why pre-post SMDs can result in biased outcomes.ResultsOne important reason why pre-post SMDs should be avoided is that the scores on baseline and post-test are not independent of each other. The value for the correlation should be used in the calculation of the SMD, while this value is typically not known. We used data from an ‘individual patient data’ meta-analysis of trials comparing cognitive behaviour therapy and anti-depressive medication, to show that this problem can lead to considerable errors in the estimation of the SMDs. Another even more important reason why pre-post SMDs should be avoided in meta-analyses is that they are influenced by natural processes and characteristics of the patients and settings, and these cannot be discerned from the effects of the intervention. Between-group SMDs are much better because they control for such variables and these variables only affect the between group SMD when they are related to the effects of the intervention.ConclusionsWe conclude that pre-post SMDs should be avoided in meta-analyses as using them probably results in biased outcomes.

scholarly journals P.041 Adult craniopharyngioma: case series, systematic review and meta-analysis

2017 ◽  
Vol 44 (S2) ◽  
pp. S24-S24
Author(s):  
C Dandurand ◽  
AA Sepehry ◽  
MH Asadi Lari ◽  
R Akagami ◽  
PA Gooderham
Keyword(s):  
Meta Analysis ◽  
Case Series ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Total Resection ◽  
Childhood Population ◽  
Institutional Experience ◽  
The Difference ◽  
Meta Analyses ◽  
Case Basis

Background: The optimal therapeutic approach for adult craniopharyngioma remains controversial. Some advocate for gross total resection (GTR), while others support subtotal resection followed by adjuvant radiotherapy (STR + XRT). Methods: MEDLINE (1946 to July 1st 2016) and EMBASE (1980 to June 30th 2016) were systematically reviewed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. At our institution, from 1975 to 2013, 33 patients were treated with initial surgical resection for adult onset craniopharyngioma. 22 patients were included in the present case series. Results: Eligible studies (n=21) were identified from the literature in addition to a case series of our institutional experience. Three groups were available for analysis: GTR, STR + XRT, and STR. The rates of recurrence were 17 %, 27 % and 45%, respectively. This differs from childhood population. The difference in risk of recurrence after GTR vs. STR + XRT did not reach significance (OR: 0.63, 95% confidence interval: 0.33-1.24, P=0.18). This maybe because of low pooled sample size (n=99) who underwent STR+XRT. Conclusions: This is the first and largest meta-analysis examining rate of recurrence in adult craniopharyngioma. Thus, when safe and feasible, a goal of gross total resection should be favored. Each patient should be considered on a case-by-case basis.

scholarly journals Prevalence of and risk factors for Plasmodium spp. co-infection with hepatitis B virus: a systematic review and meta-analysis

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Kwuntida Uthaisar Kotepui ◽  
Manas Kotepui
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Hepatitis B Virus ◽  
Meta Analysis ◽  
Infection Group ◽  
Pooled Prevalence ◽  
B Virus ◽  
The Difference ◽  
Meta Analyses

Abstract Background Plasmodium spp. and hepatitis B virus (HBV) are among the most common infectious diseases in underdeveloped countries. This study aimed to determine the prevalence of Plasmodium spp. and HBV co-infection in people living in endemic areas of both diseases and to assess the risk factors related to this co-infection. Methods The PubMed, Web of Science, and Scopus databases were searched. Observational cross-sectional studies and retrospective studies assessing the prevalence of Plasmodium species and HBV co-infection were examined. The methodological quality of the included studies was assessed with the Newcastle-Ottawa Scale (NOS), a tool for assessing the quality of nonrandomized studies in meta-analyses, and heterogeneity among the included studies was assessed with Cochran's Q test and the I2 (inconsistency) statistic. The pooled prevalence of the co-infection and its 95% confidence interval (CI) were estimated using the random-effects model, depending on the amount of heterogeneity there was among the included studies. The pooled odds ratio (OR) represented the difference in qualitative variables, whereas the pooled mean difference (MD) represented the difference in quantitative variables. Meta-analyses of the potential risk factors for Plasmodium spp. and HBV co-infection, including patient age and gender, were identified and represented as pooled odds ratios (OR) and 95% CIs. Publication bias among the included studies was assessed by visual inspection of a funnel plot to search for asymmetry. Results Twenty-two studies were included in the present systematic review and meta-analysis. Overall, the pooled prevalence estimate of Plasmodium spp. and HBV co-infection was 6% (95% CI 4–7%, Cochran's Q statistic < 0.001, I2: 95.8%), with prevalences of 10% in Gambia (95% CI: 8–12%, weight: 4.95%), 8% in Italy (95% CI 5–12%, weight: 3.8%), 7% in Nigeria (95% CI 4–10%, weight: 53.5%), and 4% in Brazil (95% CI 2–5%, weight: 19.9%). The pooled prevalence estimate of Plasmodium spp. and HBV co-infection was higher in studies published before 2015 (7%, 95% CI 4–9%, Cochran's Q statistic < 0.001, I2: 96%) than in those published since 2015 (3%, 95% CI 1–5%, Cochran's Q statistic < 0.001, I2: 81.3%). No difference in age and risk of Plasmodium spp. and HBV co-infection group was found between the Plasmodium spp. and HBV co-infection and the Plasmodium monoinfection group (p: 0.48, OR: 1.33, 95% CI 0.60–2.96). No difference in gender and risk of Plasmodium spp. and HBV co-infection group was found between the Plasmodium spp. and HBV co-infection and HBV co-infection group and the Plasmodium monoinfection group (p: 0.09, OR: 2.79, 95% CI 0.86–9.10). No differences in mean aspartate aminotransferase (AST), mean alanine aminotransferase (ALT), or mean total bilirubin levels were found (p > 0.05) between the Plasmodium spp. and HBV co-infection group and the Plasmodium monoinfection group. Conclusions The present study revealed the prevalence of Plasmodium spp. and HBV co-infection, which will help in understanding co-infection and designing treatment strategies. Future studies assessing the interaction between Plasmodium spp. and HBV are recommended.

Pectoralis Major Onlay vs Interpositional Reconstruction Fistulation After Salvage Total Laryngectomy: Systematic Review and Meta-analysis

2020 ◽  
pp. 019459982095796
Author(s):  
Claudia I. Cabrera ◽  
Alexander Joseph Jones ◽  
Noah Philleo Parker ◽  
Amy Emily Lynn Blevins ◽  
Mark S. Weidenbecher
Keyword(s):  
Systematic Review ◽  
Total Laryngectomy ◽  
Primary Closure ◽  
Conservative Therapy ◽  
Meta Analysis ◽  
Pectoralis Major ◽  
Pectoralis Major Flap ◽  
The Difference ◽  
Meta Analyses ◽  
English Articles

Objective To evaluate the difference in pharygocutaneous fistula (PCF) development between pectoralis major flap onlay and interpositional reconstructions after salvage total laryngectomy (STL). Data Sources Medline, Cochrane, Embase, Web of Science, CINAHL, and ClinicalTrials.gov. Review Methods A systematic review was performed during January 2020. English articles were included that described minor and major PCF rates after STL reconstructed with pectoralis major onlay or interposition. PCFs were classified as major when conservative therapy was unsuccessful and/or revision surgery was needed. Articles describing total laryngopharyngectomies were excluded. Meta-analyses of the resulting data were performed. Results Twenty-four articles met final criteria amassing 1304 patients. Three articles compared onlay with interposition, and 18 compared onlay with primary closure. Pectoralis interposition demonstrated elevated odds ratio (OR) of PCF formation as compared with onlay (OR, 2.34; P < .001). Onlay reconstruction reduced overall (OR, 0.32; P < .001) and major (OR, 0.21; P < .001) PCF development as compared with primary pharyngeal closure alone. Data were insufficient to compare interposition against primary closure. Conclusions This research shows evidence that pectoralis onlay after STL diminishes the odds of total and major PCF development. Pectoralis interposition reconstruction showed elevated odds of PCF formation as compared with pectoralis onlay.

scholarly journals Waist height ratio predicts chronic kidney disease: a systematic review and meta-analysis, 1998–2019

2019 ◽  
Vol 77 (1) ◽  
Author(s):  
Ling Liu ◽  
Yanqiu Wang ◽  
Wanjun Zhang ◽  
Weiwei Chang ◽  
Yuelong Jin ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Statistical Difference ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Cochrane Library ◽  
Height Ratio ◽  
Physical Measurements ◽  
Significant Difference ◽  
The Difference

Abstract Background The incidence of chronic kidney disease (CKD) increases each year, and obesity is an important risk factor for CKD. The main anthropometric indicators currently reflecting obesity are body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), but the rationality and merits of various indicators vary. This article aims to find whether the WHtR is a more suitable physical measurement that can predict CKD. Methods Pubmed, embase, the cochrane library, and web of science were systematically searched for articles published between 1998 and 2019 screening CKD through physical indicators. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the methodology included in the study. Meta-analysis used the Stata 12.0 software. Results Nine studies were included, with a total of 202,283 subjects. Meta-analysis showed that according to the analysis of different genders in 6 studies, regardless of sex, WHtR was the area with the largest area under the curve (AUC). Except WHtR and visceral fat index (VFI) in women which showed no statistical difference, WHtR and other indicators were statistically different. In three studies without gender-based stratification, the area under the curve AUC for WHtR remained the largest, but only the difference between WHtR and BMI was statistically significant. When the Chinese population was considered as a subgroup, the area under the curve AUC for WHtR was the largest. Except for WHtR and VFI which showed no statistical difference in women, there was a statistically significant difference between WHtR and other indicators in men and women. Conclusion WHtR could be better prediction for CKD relative to other physical measurements. It also requires higher-quality prospective studies to verify the clinical application of WHtR.

scholarly journals A Meta-Analysis on the Effect of Complex Training on Vertical Jump Performance

2020 ◽  
Vol 71 (1) ◽  
pp. 255-265
Author(s):  
Jeffrey Pagaduan ◽  
Haris Pojskic
Keyword(s):  
Meta Analysis ◽  
Vertical Jump ◽  
The Other ◽  
Plyometric Training ◽  
Jump Performance ◽  
Other Hand ◽  
Plyometric Exercise ◽  
Traditional Resistance Training ◽  
Complex Training ◽  
The Difference

AbstractComplex training (CT) is a strength training intervention performed by completing all the sets of a resistance exercise followed by a series of high-velocity/plyometric exercise/s. The purpose of this novel study was to conduct a meta-analysis on the effect of CT on vertical jump (VJ) performance. Five electronic databases were searched using terms related to CT and the VJ. Studies needed to include randomized trials comparing CT with traditional resistance training (RT)/plyometric training (PLYO)/control (CON) lasting ≥ 4 weeks and the VJ as a dependent variable. Seven studies qualified for the meta-analysis with two studies differentiating VJ performance from CT and RT, two studies comparing VJ performance of CT and PLYO, and two studies establishing the difference in VJ performance between CT and CON. Results indicated similar improvement in VJ performance from CT and RT (p = 0.88). On the other hand, greater VJ performance in CT than PLYO was identified (ES = 0.86; 95% CI 0.24, 1.47; p = 0.01). CT also showed significantly greater enhancement in VJ compared to CON (ES = 1.14; 95% CI 0.60, 1.68; p < 0.01). In conclusion, CT can serve as alternative training from RT in improving VJ performance. On the other hand, CT is a better option in VJ enhancement than PLYO and CON.

scholarly journals Meta-Analysis of Efficacy and Safety of Tadalafil Plus Tamsulosin Compared with Tadalafil Alone in Treating Men with Benign Prostatic Hyperplasia and Erectile Dysfunction

2019 ◽  
Vol 13 (5) ◽  
pp. 155798831988259 ◽  
Author(s):  
Zhongbao Zhou ◽  
Xuesong Zheng ◽  
Jitao Wu ◽  
Zhenli Gao ◽  
Zhunan Xu ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Meta Analysis ◽  
Prostatic Hyperplasia ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
The Difference ◽  
Meta Analyses

This meta-analysis was performed to evaluate the efficacy and safety of tadalafil plus tamsulosin compared with tadalafil alone in treating men with benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) after 12 weeks’ treatment. Systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched to collect randomized controlled trials. The references of related articles were also searched. Four articles including 621 patients were involved in the analysis. The study identified that combination-therapy had significant improvements in total international prostate symptom score (IPSS), quality of life (QoL) and maximum urine flow rate (Qmax) compared with monotherapy, and there were no obvious significance in respects of post-void residual volume, international index of erectile function and IPSS storage. The difference of total IPSS was mainly reflected in the change of IPSS voiding. For safety, combination-therapy had a higher incidence rate of any adverse events (AEs) and discontinuation due to AEs than monotherapy with the exception of pain. In conclusion, the combination of tadalafil and tamsulosin provided a better improvement of IPSS voiding, QoL and Qmax compared with tadalafil alone in treating men with BPH and ED, and the former therapy appeared to show a higher incidence of AEs.

Abstract P274: A meta-analysis of meta-analyses: Is "reverse Epi" OK or not?

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Ken Williams ◽  
Allan D Sniderman
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Geometric Mean ◽  
Point Estimate ◽  
Risk Models ◽  
Percentage Difference ◽  
Chd Risk ◽  
The Difference ◽  
Meta Analyses ◽  
Stratified Analysis

Introduction: Applications of observational risk models assuming “all else equal” to estimate the effect on risk of interventions expected to change the level of one or more independent variables have been criticized as “reverse Epi” since clinical trials provide better estimates of treatment effects. Hypothesis: The purpose of this analysis is to assess how reasonable it is to use “reverse Epi” to project the number of events avoided under different scenarios in which different markers are used for determining to whom to prescribe and how to target preventative treatment. We pursued this aim by comparing two different meta-analyses which compared HRs for apoB and non-HDL-C. One meta-analysis included 12 published observational studies. In 11 of these studies all subjects were at primary CHD risk. The other meta-analysis included 7 placebo-controlled statin trials (3 primary and 4 secondary). Methods: We calculated the reciprocal of each observational study’s HR per 1-SD increase (36 mg/dl for non-HDL-C and 27 mg/dl of apoB) to compare with each trials’ HR per 1-SD decrease; calculated the percentage difference (95% CI) in standard HRs for each report assuming a correlation between the two markers of 0.93 (calculated from NHANES 2005-2010 to be representative of adult US residents); and compared the resulting statistics using standard subgroup meta-analysis. Results: The overall geometric mean point estimate (95% CI) of the difference favoring apoB over non-HDL-C for all observational studies was 11.1% (7.7%, 14.4%) versus 5.4% (2.9%, 9.2%) for all 7 trials (p = 0.007). However these same point estimates are 9.5% (7.3%, 14.0%) versus 10.6% (7.3%, 14.0%) (p=0.714) when only primary studies or trials were included. The geometric mean treatment effect HR among the 4 secondary trials was 0.732 (0.689, 0.792) versus 0.599 (0.504, 0.714) among the 3 primary trials (p = 0.035). Conclusion: Meaningful differences between primary and secondary observational and interventional studies warrant stratified analysis. Among subjects at primary CHD risk, “reverse Epi” application of primary observational results may provide projections similar to those from applying primary trial results.

scholarly journals Mammalian herbivory exacerbates plant community responses to long-term increased soil nutrients in two Alaskan tundra plant communities

2018 ◽  
Vol 4 (2) ◽  
pp. 153-166 ◽  
Author(s):  
Laura Gough ◽  
David R. Johnson
Keyword(s):  
Plant Communities ◽  
Field Experiments ◽  
Meta Analysis ◽  
Top Down ◽  
Betula Nana ◽  
Community Changes ◽  
The Difference ◽  
Meta Analyses ◽  
Alaskan Tundra

The interaction between bottom-up and top-down forces in regulating plant communities is a long-standing topic of interest in ecology. Factorial field experiments examining these factors have been relatively few, but recent meta-analyses provide predictions that can be tested in a range of ecosystems. We tested the prediction that added nutrients would reduce species richness and evenness, while herbivore activity would offset those changes in two tundra plant communities after 11 years. In moist acidic tundra (MAT), herbivores reduced richness more in fertilized plots when mammals were present compared with fertilized plots without herbivores. In dry heath (DH), evenness was significantly reduced in fertilized plots only when herbivores were present, also providing evidence that herbivores enhanced community changes caused by greater nutrient availability. The difference in response between MAT and the meta-analysis predictions appears to be driven by Betula nana, the species that dramatically increased with added nutrients in MAT. Unlike in similar studies and in DH, B. nana is not as palatable as most of the species in the community and is generally avoided by herbivores. These results highlight how the effects of herbivory and nutrients differ across communities and can be affected by the traits of the species present.

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